Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mikayla C Moore

Individual provider Clinical Psychologist · NPI 1104691781

Mikayla C Moore is a Clinical Psychologist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2023.

Licensed in
MI
In the registry since
2023

Practice location Address checks out

330 E Beltline Ave NE Ste 320
Grand Rapids, MI 49506-1267
Phone: (616) 745-8640
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 6362009854 (MI)

Record details

NPI number1104691781
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 23, 2023
Last updated in NPPESNovember 23, 2023
Certification dateNovember 23, 2023

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